Libby speaks out against Bill C-2 and in support of safe injection sites

House of Commons

HANSARD

October 18, 2013

Ms. Libby Davies (Vancouver East, NDP):

Mr. Speaker, it has been interesting to listen to the parliamentary secretary present this bill today and it is very important that we look back at the history of this case and begin with the Supreme Court of Canada decision in 2011, because it has been referenced a lot. If we can just remember, Insite, as I mentioned earlier, did go through a rigorous process to establish itself in the city of Vancouver and has been a very successful operation in saving people’s lives, preventing overdoses and improving public safety in the neighbourhood. But of course, it was challenged all the way by the Conservative government and it did end up at the Supreme Court of Canada which ruled that Insite was a very important health facility. I want to quote a very key part of its ruling because it is based on this ruling that supposedly this legislation is now before us. The Supreme Court of Canada ruling said:

On future applications, the minister must exercise discretion within the constraints imposed by law and the charter, aiming to strike an appropriate balance between achieving public health and public safety. In accordance with the charter, the minister must consider whether denying an exemption would cause deprivations of life and security of the person that are not in accordance with the principles of fundamental justice. Whereas here a supervised injection site will decrease the risk of death and disease and where there is little or no evidence that it will have a negative impact on public safety, the minister should generally grant the exemption.

That is what the Supreme Court of Canada said. What was the government’s response to that? Reading from the press release that the Minister of Health issued June 6 when the bill was first introduced, she began by saying:

Our government believes that creating a location for sanctioned use of drugs obtained from illicit sources has the potential for great harm in a community.

There was nothing in this press release and in fact when one reads the bill, there is nothing in it that strikes the balance that was referenced by the Supreme Court of Canada for public health and public safety. From the very beginning, from the get-go, it has been very clear that the bill is a stacked deck, that it is designed to frustrate and to make it virtually impossible for any safe injection site to be established in this country.

One has to ask the question, why is the government so biased on this issue? Why have Conservatives refused to consider all of the evidence that has been put before them? We just had the recent situation, a very similar case where the Minister of Health overruled her own experts on an application that was approved to provide heroin maintenance in Vancouver’s downtown east side in the inner city.

It was quite astounding to see that the minister ignored all of the evidence, overruled her experts, stepped in, intervened and made it clear that this special application that had been approved by her officials would not go ahead.

What was most disturbing was to see that in both of these cases, the safe injection site bill and also the application for heroin maintenance, within 24 hours this became a fundraising letter for the Conservative Party of Canada. Imagine that government legislation and an intervention and interference by the minister is catapulted and turned into a fundraiser for the Conservatives’ base.

I find that really alarming and it illuminates for us what this debate is really about. It is about creating an environment of fear. It’s about creating an environment of division. It is about creating an environment based on them and us. It is about an environment that the Conservatives want to escalate that demonizes people who use drugs and people who are facing serious addiction issues.

The parliamentary secretary made some references to the bill and when we actually read through the bill to see what is required, it is quite incredible. First of all, the parliamentary secretary said that the minister must consider criteria that are laid out as part of a submission for an application to set up a safe injection site in any particular community. But clearly what the bill says is that “the minister may consider an application” once the application has been submitted and the criteria met. It is not even that she must then look at it, she may. Even the discretion takes place at that level.

When we look at the criteria, in the bill it literally goes from (a) to (z), there are 26 different criteria considerations that are so onerous and so stacked that it would make it virtually impossible to even meet the criteria laid out in the bill.

For example, it requires a letter from the provincial ministers responsible for health. It requires a letter from the local municipal government. It requires a letter from the head of the police force, outlining any issues that they have. It requires a letter from the leading health professional organization. It requires a letter from the provincial minister responsible for public safety. It requires a statistical analysis. It requires police checks for people. It requires extensive public consultation.

All of this has to be gathered in addition to a 90-day public notification period that the minister herself can also conduct. There are two streams of information coming in, and even then, as we can see from the bill, the minister actually does not have to consider the application.

Once this information has been gathered, there is further consideration in the bill, section 5, that lays out that the minister may only grant an exemption under the Controlled Drugs and Substances Act after having considered the following principles. I think these principles clearly lay out the government’s intent.

The principles are: illicit substances may have serious health effects; adulterated controlled substances may pose health risks; the risks of overdose are inherent in the use of certain illicit substances; strict controls are required; organized crime profits from the use of illicit substances; and criminal activity often results from the use of illicit substances.

What I find really curious about these principles that this bill is based on is that there is absolutely no mention of public health. There is no mention of preventing overdoses. There is no mention of preventing serious infections, like HIV-AIDS or hepatitis C. There is no mention, no principle of ensuring basic public health or protecting public safety.

What are the principles about? Clearly, they are about frustrating any application and giving the minister so much room that she can easily turn down any application, if she even decides to consider it in the first place. We attended the briefing that the government gave on the bill, and in that brief it was made very clear that if the criteria are met, the application may be considered but it will not necessarily be approved.

We find this bill offensive, and we will be opposing it. Clearly the bill does not live up to the spirit and the intent of the Supreme Court of Canada ruling. It is designed to frustrate that ruling, and in fact I would suggest that there will probably be ongoing legal challenges about this legislation. This bill is designed to create a situation where everything will run in the government’s favour to not even consider applications or, if it does, to simply turn it down based on the principles that it has outlined.

Let us just take a couple of minutes to talk about the one case that we do have in Canada, which is called Insite in Vancouver’s downtown east side. Setting up Insite was probably the most important health measure that has ever been taken in this country. It took years for it to be up and running. It went under incredible local scrutiny. There was opposition.

In Vancouver today, not only do the police support the safe injection site, as well as local businesses, the board of trade, and municipal politicians. In fact, I think members would be hard pressed to find anyone in Vancouver who would actually dispute the value and the importance of this particular facility that is located on East Hastings Street.

The facility has been scrutinized and has been the subject of 30 scientific studies and reports. It has gone through enormous evaluation.

However, what I think is most important is that if we actually visit the place, we can see for ourselves what work is being done and how important it is to provide a safe, medically-supervised environment for people with serious addiction issues to get off the street, to be in an environment where they are safe, where they are taken care of, and where they can make contact with health care professionals.

I have seen that because most of the people who use this facility are my constituents. I know many of them personally.

What I find really just incredibly disappointing is that no minister of health has had the courage, or even just the reasonable wherewithal, to actually visit Insite to find out for themselves what is going on.

So, all of this rhetoric, all of this bias that the Conservatives show is based upon an ideology that they are perpetuating. It is not based upon either experience of first-hand knowledge. It is not based upon consideration of the incredible body of evidence that now exists. It is simply based upon a political position that they have staked out because they think it caters to a Conservative base.

I find that really quite abhorrent, in terms of how we approach public policy in this country.

I do not know how much money has been spent on all of the litigation involving Insite. It is probably in the hundreds of thousands of dollars. Yet, this facility in Vancouver has survived. It has survived all the way to the Supreme Court of Canada and is still continuing to operate.

In fact, just a few weeks ago it celebrated–and I use the word “celebrate” because it was a celebratory event–its 10th anniversary. To see the people in the community who have become part of the clientele of Insite, to see the people who are actually still alive, who are better off, who are doing better, who are better connected, who have a health connection are very important things. Without Insite, many of those individuals would likely have died of overdoses.

However, is there anything in the bill that would address that, the simple basic human fact that Insite is part of the solution, not part of the problem? We do not see anything in the bill on those issues.

I know that the government has come under intense scrutiny and criticism from a number of organizations across the country, which of course it has ignored. For example, the Canadian HIV/AIDS Legal Network, the Canadian Drug Policy Coalition, and the Pivot Legal Society issued a statement in which they made it very clear that:

People who use drugs are entitled to needed health care services just like all other Canadians. It is unethical, unconstitutional and damaging to both public health and the public purse to block access to supervised consumption services which save lives and prevent the spread of infections.

I think that is it, in a nutshell. What we are talking about here is public health. It is about community safety. It is about people giving people very basic access to health services. Yet, we would never know that by looking at this legislation, we would never know that by reading the minister’s press release, and we would never know that by listening to the rhetoric that we heard from the government side on this bill, and on the issue, generally.

The Canadian Medical Association issued a press release when the bill first came out, in June, in which it said:

The CMA is deeply concerned that the proposed legislation may be creating unnecessary obstacles and burdens that could ultimately deter creation of more injection sites.

Dr. Evan Wood, a renowned scientist who works for the BC Centre of Excellence in HIV/AIDS, points out that one of the important aspects of a safe injection site is that given that each HIV infection costs on average approximately $500,000 in medical costs, Insight has contributed to a 90% reduction in new HIV cases caused by intravenous drug use in British Columbia, which is why the British Columbia government has been such a strong supporter of the program. That is from an article he wrote in The Globe and Mail in June.

We also have Dr. Mark Tyndall who is the head of infectious diseases at Ottawa Hospital. He says:

Supervised injection sites will be open in Canada and the government will be challenged for its callous and misinformed policies through legal avenues and whatever else it takes to do the right thing. Thousands of Canadians—the poor, the addicted, the mentally ill, our brothers and sisters—are depending on it.

These are just a few of the opinions and analyses that have come in from people who have studied this issue over and over again.

We need to understand that if this bill goes through, not only would it prevent other safe injection sites from being set up in Canada, and we do know that there is a great interest in Toronto, Victoria and Montreal, but it would also have an impact in Vancouver. As the parliamentary secretary pointed out, the current exemption permit for Insite will be up in March 2014 so they too will have to go through this process. Given the incredibly ridiculous and absurd criteria and considering the stance of the government, we can see that approval is very unlikely, or it will be very difficult to get.

What does that mean? It means that a place that has been operating successfully for 10 years, that has been well accepted in the community and that went through all of the approval processes will potentially be shut down, and people will be turfed out on the street. It means that people will die of overdoses. It means that we will see open drug use on the streets. It means that we will see greater pain and suffering in this community and the whole community will be impacted by that.

I want to keep coming back to the most basic point of this whole debate, and that is that a safe injection site is not some kind of bogey man or some kind of scary place; it is simply a health facility. It is a health facility that provides a service that helps people who are facing very difficult addiction issues. It provides a safe, medical and supervised environment. It helps people get into treatment. It helps people get off the street. Most important, it stops people from dying of overdoses.

Does that mean anything to these Conservatives? Do they even care that people are dying? What they want to do is vilify those people. We heard the parliamentary secretary. She talks about her mother and somebody else’s mother walking down the street. This is about creating fear in local communities. Maybe that is the reason, as my colleague has pointed out, that this bill is going to go to the public safety committee, because the Conservatives want to have it viewed only through a lens of law and order, as opposed to a needed, necessary and essential public health approach that is about public health and public protection for people, not only the drug users but the community as a whole.

This bill that we have before us is the antithesis of a public health approach. What is this bill really about? It is about fear. It is about dividing people. It is about demonizing people. I find that really offensive because we are talking about individuals. Drug use cuts across all classes. It cuts across people of all different persuasions. So we have to examine that this bill is something that would hurt not only the existing safe injection site but the potential for others across the country that would save lives.

I will finish my remarks by moving a motion. I move, seconded by the member for Notre-Dame-de-Grâce—Lachine:

That the motion be amended by deleting all the words after the word “That” and substituting the following: this House decline to give second reading to Bill C-2, an Act to amend the Controlled Drugs and Substances Act, because it:

(a) fails to reflect the dual purposes of the Controlled Drugs and Substances Act (CDSA) to maintain and promote both public health and public safety; (b) runs counter to the Supreme Court of Canada’s decision in Canada v. PHS Community Services Society, which states that a Minister should generally grant an exemption when there is proof that a supervised injection site will decrease the risk of death and disease, and when there is little or no evidence that it will have a negative impact on public safety; and

(c) establishes onerous requirements for applicants that will create unjustified barriers for the establishment of safe injection sites, which are proven to save lives and increase health outcomes.

(d) further advances the Miniister’s political tactics to divide communities and use the issue of supervised injection sites for political gain, in place of respecting the advice and opinion of public health experts.